Introduction to FAST Sonography

Focused Assessment with Sonography for Trauma (FAST) is a rapid bedside ultrasound procedure for assessing patients with potential abdominal trauma or bleeding.

Developed in the 1970s, FAST was initially used in Europe before gaining widespread adoption in the US as a standard trauma assessment tool during the 1990s.

FAST sonography targets four specific areas: the pericardial area and the abdomen's right upper quadrant, left upper quadrant, and pelvis, searching for free fluid.

FAST is highly effective in detecting hemoperitoneum. Studies show it detects intraperitoneal bleeding with a sensitivity of 60-98%, depending on operator experience.

Extended FAST (E-FAST) includes thoracic examination, checking for pneumothorax and hemothorax, making the assessment even more comprehensive for trauma patients.

While designed for trauma, FAST is now utilized in non-trauma cases as well, including diagnosing heart failure, assessing shock, and guiding fluid resuscitation.

Despite its utility, FAST has limitations. It's less sensitive for detecting organ injury, retroperitoneal and bowel injuries, and can be hampered by obesity and subcutaneous air.